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Tiffany Truong, Zvi Kresch, Sanjay Kedhar, Vicente Diaz, John Mauro, C. Michael Samson; Comparison of Methotrexate and Mycophenolate in the Treatment of Chronic Uveitis. Invest. Ophthalmol. Vis. Sci. 2013;54(15):124. doi: https://doi.org/.
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To compare efficacy and side effects of methotrexate and mycophenolate in the treatment of chronic non-infectious uveitis.
Charts of patients seen by the New York Eye & Ear Infirmary Uveitis Service in 2004-2005 who were treated with either methotrexate or mycophenolate and had follow-up data for a minimum of three years after initiation of medication were reviewed. Statistical analysis was performed comparing aspects of efficacy and tolerability, such as ability to control inflammation, time to control inflammation, ability to prevent vision loss, and incidence of side effects.
A total of 95 patients were included in the study. Control of inflammation at 1, 2, and 3 years after initiating medication was statistically equal between the two groups, ranging from 71% to 80% with mycophenolate, and 67% to 70% with methotrexate. Mycophenolate achieved control of inflammation faster than methotrexate at 6 and 9 months (p=.0179, .0485 respectively), but the drugs evened out in the long run. Visual acuity was preserved equally in both groups. Side effects were minimal in both groups.
Both methotrexate and mycophenolate have equal ability to control inflammation and prevent vision loss in patients with chronic uveitis who are either unresponsive or intolerant of steroid treatment. Mycophenolate achieves control of inflammation more quickly in the 6 to 9 month range, but the drugs are equal at 1 year and longer. Both drugs are tolerated with minimal side effects. This is the first report of a comparison of these two drugs in a cohort at a single treatment center.
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